Evidence map›Paper›PMID 18194573›Full record

SynthesisBMC public health2008

A systematic review of delay in the diagnosis and treatment of tuberculosis.

Dag Gundersen Storla, Solomon Yimer, Gunnar Aksel Bjune

2 registry-linked trialsAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC public health, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 502 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
502citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04434976 completednot on this mapstarted 2019, after this paper: background citation

Delayed Diagnosis of Bacteriologically Positive Pulmonary Tuberculosis and Relative Optimized Suggestions in China

TypeobservationalSponsorHuashan HospitalRan2019 to 2020Enrolled400ConditionsTuberculosis, Pulmonary, Confirmed, Unspecified Means
NCT07517471 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Start4All - Start Taking Action for TB Diagnosis SCREEN-TB

TypeinterventionalSponsorLiverpool School of Tropical MedicineRan2026 to 2027Enrolled37,000ConditionsTB - TuberculosisArmsNear point of care (NPOC) NAATs, Low-complexity nucleic acid amplification tests (LC-NAATs), LC-NAAT using pooled testing, Portable Chest X-ray Image Acquisition, Computer-Aided Detection (CAD) Chest X-ray (CXR-AI)
3 · Its place in the literature

Who cites it

502 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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442 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Dag Gundersen StorlaDepartment of International Health, Institute of General Practice and Community Medicine, University of Oslo, PO Box 1130 Blindern, N-0318 Oslo, Norway. dgstorla@online.no
Solomon Yimer
Gunnar Aksel Bjune

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly diagnosis and immediate initiation of treatment are essential for an effective tuberculosis (TB) control program. Delay in diagnosis is significant to both disease prognosis at the individual level and transmission within the community. Most transmissions occur between the onset of cough and initiation of treatment.

methodsA systematic review of 58 studies addressing delay in diagnosis and treatment of TB was performed. We found different definitions of, for example, debut of symptoms, first appropriate health care provider, time to diagnosis, and start of treatment. Rather than excluding studies that failed to meet strict scientific criteria (like in a meta-analysis), we tried to extract the "solid findings" from all of them to arrive on a more global understanding of diagnostic delay in TB.

resultsThe main factors associated with diagnostic delay included human immunodeficiency virus; coexistence of chronic cough and/or other lung diseases; negative sputum smear; extrapulmonary TB; rural residence; low access (geographical or sociopsychological barriers); initial visitation of a government low-level healthcare facility, private practitioner, or traditional healer; old age; poverty; female sex; alcoholism and substance abuse; history of immigration; low educational level; low awareness of TB; incomprehensive beliefs; self-treatment; and stigma.

conclusionThe core problem in delay of diagnosis and treatment seemed to be a vicious cycle of repeated visits at the same healthcare level, resulting in nonspecific antibiotic treatment and failure to access specialized TB services. Once generation of a specific diagnosis was in reach, TB treatment was initiated within a reasonable period of time.

Indexed as

Diagnostic ErrorsFemaleHIV InfectionsHumansMaleObservationPatient Acceptance of Health CareRisk FactorsSocioeconomic FactorsTime FactorsTuberculosis, Pulmonary

Identifiers

PMID18194573
PMCPMC2265684

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.